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Clinical characteristics and risk factors for severe pertussis in infants aged less than 3 months

Xiaoyan Zeng1, Ling Wang1, Xiumin Yuan1

  • 1Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei, China.

Translational Pediatrics
|August 13, 2026
PubMed

Insights

Severe pertussis in infants under 3 months occurs in 13.2% of cases. Fever, cyanotic episodes, high white blood cell counts, and pulmonary consolidation increase severity risk, while whooping cough may lower it.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Pertussis, caused by *Bordetella pertussis*, is a significant global health concern.
  • Research on pertussis in infants under 3 months is limited, despite their vulnerability.
  • This study addresses the clinical characteristics and risk factors for severe pertussis in this specific age group.

Purpose of the Study:

  • To analyze the clinical presentation of pertussis in infants younger than 3 months.
  • To identify risk factors associated with severe pertussis in hospitalized infants under 3 months.
  • To provide insights into the management and prevention of severe pertussis in neonates and young infants.

Main Methods:

  • Retrospective analysis of clinical data from 205 infants hospitalized with pertussis (age <3 months).
  • Utilized multivariate logistic regression to identify independent risk factors for severe pertussis.
  • Data collected from a provincial-level tertiary referral center in Anhui, China.

Main Results:

  • The incidence of severe pertussis was 13.2% (27/205 infants).
  • Severe cases were significantly associated with cyanotic episodes, whooping cough, fever, maximum white blood cell (WBC) count >30×10^9/L, and pulmonary consolidation.
  • Multivariate analysis confirmed fever, cyanotic episodes, elevated WBC count, and pulmonary consolidation as independent risk factors for severe disease.

Conclusions:

  • Fever, cyanotic episodes, high WBC counts (>30×10^9/L), and pulmonary consolidation are key indicators of severe pertussis in infants under 3 months.
  • Interestingly, whooping cough was associated with a lower risk of severe disease in this cohort.
  • These findings highlight critical clinical markers for early identification and intervention in young infants with pertussis.
Abstract

Keywords:
Clinical characteristicsinfantpertussisrisk factorssevere disease

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